Yang Chiu-Yueh, Wang Ying-Jan, Chen Pau-Chung, Tsai Shaw-Jenq, Guo Yueliang Leon
The Institute of Basic Medical Sciences, National Cheng Kung University Medical College, Tainan, Taiwan.
Environ Health Perspect. 2008 May;116(5):599-604. doi: 10.1289/ehp.10715.
Polychlorinated biphenyls (PCBs), dibenzofurans (PCDFs), and dibenzodioxins (PCDDs) may affect the female reproductive system in animals and humans. In 1978-1979, a mass poisoning occurred in central Taiwan due to PCB/PCDF-contaminated cooking oil; this incident was called Yucheng ("oil disease" in Chinese).
The purpose of our study was to determine whether PCB/PCDF exposure affected fertility in exposed women.
After the event, we followed the exposed individuals and a reference group who were sex-, age-, and community-matched. In 2003, we obtained fertility histories from Yucheng and reference women by telephone interview. We used Kaplan-Meier survival curves and multivariable Cox regression to compare time to pregnancy (TTP) between Yucheng and reference women, and we performed multiple logistic regression to determine whether PCB/PCDF exposure caused infertility.
In total, 412 women responded, with a median TTP of 4 months in Yucheng women and 3 months in reference women (p = 0.019). After adjusting for confounders by Cox regression, we found a fecundability ratio of 0.90 [95% confidence interval (CI), 0.80-1.00] for Yucheng women. Among the 408 women who had non-contraceptive sexual activity for > 12 months, 19.7% of Yucheng women and 9.7% of reference women did not become pregnant (i.e., they were infertile). After we adjusted for confounders by logistic regression, the infertility odds ratio was 2.34 (95% CI, 1.23-4.59) for Yucheng women compared with the reference group.
We found prolonged TTP and reduced fertility among women previously exposed to PCBs/PCDFs. Because of the limited sample size and the relatively small decrease in the fertility rate, these effects require cautious interpretation and further investigation for confirmation.
多氯联苯(PCBs)、多氯二苯并呋喃(PCDFs)和多氯二苯并二恶英(PCDDs)可能会影响动物和人类的女性生殖系统。1978 - 1979年,台湾中部发生了一起因受多氯联苯/多氯二苯并呋喃污染的食用油导致的大规模中毒事件;这一事件被称为“油症”(中文意思)。
我们研究的目的是确定多氯联苯/多氯二苯并呋喃暴露是否会影响暴露女性的生育能力。
事件发生后,我们对暴露个体以及按性别、年龄和社区匹配的对照组进行了随访。2003年,我们通过电话访谈获取了“油症”女性和对照女性的生育史。我们使用Kaplan - Meier生存曲线和多变量Cox回归来比较“油症”女性和对照女性的怀孕时间(TTP),并进行多因素逻辑回归以确定多氯联苯/多氯二苯并呋喃暴露是否导致不孕。
共有412名女性做出回应,“油症”女性的TTP中位数为4个月,对照女性为3个月(p = 0.019)。通过Cox回归对混杂因素进行调整后,我们发现“油症”女性的受孕能力比为0.90 [95%置信区间(CI),0.80 - 1.00]。在408名有超过12个月非避孕性活动的女性中,19.7%的“油症”女性和9.7%的对照女性未怀孕(即她们不孕)。通过逻辑回归对混杂因素进行调整后,与对照组相比,“油症”女性的不孕优势比为2.34(95% CI,1.23 - 4.59)。
我们发现既往暴露于多氯联苯/多氯二苯并呋喃的女性怀孕时间延长且生育能力降低。由于样本量有限且生育率下降幅度相对较小,这些影响需要谨慎解读并进一步调查以确认。